"Decompression of tension pneumothorax in a trauma patient -first use of a novel decompression colorimetric capnography device in human patient"

John Zietlow, Matthew Hernandez, Andrew Bestland, Juna Musa, Michael Ferrara, Kathleen Berns, Jeff Anderson, Martin Zielinski, Johnathon Aho

Case Reports Gen Thorac Cardiovasc Surg. 2021 Feb;69(2):391-393

Abstract

Tension pneumothorax is a common cause of mortality in trauma. Tension pneumothorax is the confinement of respired gases within the pleural cavity at increasing pressure resulting in hemodynamic collapse. Decompression is crucial in management. Emergency needle thoracostomy is a life-saving maneuver that allows atmospheric pressure equilibration and partial restoration of cardiac filling. Needle decompressions are usually performed under noisy, tense, and stressful circumstances, and objective assessment of success is difficult in the field. A device which is simple that objectively informs operators of successful decompression would be clinically useful. In previous work, we have demonstrated end-expiratory gas and gaseous composition of tension pneumothorax are similar due to increased carbon dioxide partial pressure relative to atmospheric gas composition. Therefore, a simple solution to objective needle decompression may be colorimetric capnography.We report a case of 58-year-old male treated by EMS following a motorcycle accident with left-sided chest pain, hypoxia, hypotension, and clinical findings of tension pneumothorax. Needle decompression with colorimetric capnography using the device indicated decompression of his tension pneumothorax, with appropriate temporizing success.